MaineCare Home and Community Benefits for the Elderly and Adults with Disabilities (Section 19)

MaineCare’s Section 19 waiver, Home and Community Benefits for the Elderly and Adults with Disabilities, pays for care at home for MaineCare members who meet the medical rules for nursing facility care. This page is part of our Maine Long-Term Care Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

Item	Details
Type of program	Medicaid home and community-based services (HCBS) waiver
Who runs it	Maine DHHS, Office of Aging and Disability Services (OADS)
Age	18 and older
Care need	Nursing facility medical eligibility, shown by the MED assessment
Maine 2026 income rule (long-term care)	$2,982 a month (nursing facility and waiver)
Maine 2026 asset limit (single applicant)	$2,000, plus up to $8,000 of savings excluded
Waiting list	No. OADS reported 0 waiting in 2026

Section 19 in brief

Put simply, responsibility for Section 19 sits with Maine DHHS, Office of Aging and Disability Services (OADS). Who it is for: 18 and older. Care need required: Nursing facility medical eligibility, shown by the MED assessment. Waiting list status in 2026: No. OADS reported 0 waiting in 2026. The sections below repeat these points with more detail, and our state guide covers the Maine rules that apply to every long-term care program. Other Maine programs, and general guides on care at home, are linked at the end of this page for comparison with Section 19.

What the program is

OADS runs Section 19. A face-to-face Medical Eligibility Determination (MED) assessment, done by the state’s assessing agency, decides whether a person qualifies. Services are provided by agencies or directed by the participant where allowed.

Section 19 is a “waiver” because federal Medicaid lets Maine waive certain rules in order to pay for care at home and in the community. Slots are limited each year, every participant has an individual care plan, and a case manager or coordinator puts services in place. Waiver services sit on top of regular Medicaid, which still covers doctors, hospitals and prescriptions (after Medicare, for people who have it). See our overview of HCBS waivers.

Who qualifies in 2026

In Maine, the basic requirements for Section 19 are that the person:

Is 18 or older
Meets the medical rules for nursing facility care through the MED assessment
Qualifies for full Medicaid under Maine’s long-term care financial rules (see the money test below)
Lives in Maine and is a U.S. citizen or qualified non-citizen

The money test. Applicants for Section 19 must meet Maine’s long-term care Medicaid financial rules. The income and asset figures in the table above are Maine’s 2026 Long-Term Care Medicaid figures from our state guide. MaineCare’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. When one spouse applies for Section 19 and the other stays at home, the spouse at home keeps a protected share of the couple’s assets and may receive part of the applicant’s income. See Spousal impoverishment rules.

What the care test means in practice. MaineCare’s assessment covers daily activities, from bathing and dressing to toileting and medications, plus memory and safety. For Section 19, an assessor, usually a nurse or social worker, visits the person at home, in the hospital or in the facility. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.

What services it can pay for

Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:

Personal care
Nursing
Home-delivered meals
Emergency response systems
Respite
Assistive technology
Home changes
Homemaker services
Care coordination

Not every participant gets every service; the plan reflects assessed need and the help family already gives. If needs change, ask for a new assessment.

Directing your own care and paying family

Section 19 allows participant direction for some services, so participants can hire their own workers.

How to apply

There are two tracks, a financial one and a care one, and both must say yes. The usual path for Section 19 is:

Request a MED assessment from the state’s assessing agency (arranged through OADS).
Apply for MaineCare with DHHS.
If eligible and funding is available, choose services and providers.

Our documents checklist and Applying for a waiver guide list the paperwork.

Waiting lists

Maine’s HCBS access reports show no waiting list for Section 19 in 2026: 0 people waiting and 3,718 participants in January to March, and 0 waiting and 3,778 participants in April to June. Maine’s waiting lists are in its state-funded home care programs, Section 63 (914 people waiting) and Section 69 (1,492 people waiting), not in the Section 19 waiver.

General advice is in Waiver waiting lists.

How it relates to nursing home Medicaid

Section 19 uses the same nursing facility medical eligibility and Maine’s 2026 income rule ($2,982 a month) and asset limit as nursing home MaineCare.

Rules shared with nursing home Medicaid. Maine’s financial rules for Section 19 track the nursing home rules closely. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. People who keep income above a set allowance may have to pay part of it toward their care each month.

Personal needs allowance. If the person does move to a nursing home, Maine’s 2026 personal needs allowance is $40 a month. Most of the rest of their income goes toward the cost of care. Our state guide covers the nursing home rules in detail.

Tips for families

Do not wait for a crisis. Lists and assessments for Section 19 take time, and the start date is usually when you first request help.
Document everything, from forms and letters to who you spoke with at MaineCare and when.
Watch the deadlines on notices. A denial or cut can be appealed through a fair hearing, and a timely request can keep services going meanwhile.
Tell MaineCare about changes in money, address or household as they happen.
Plan for renewals. Medicaid and the care assessment are both renewed, usually once a year. See Renewals.
Think about the spouse at home. Couples have extra protections, but they have to be claimed. A certified Medicaid planner or a legal aid office can explain how the rules apply to a particular family.

Common questions

Can I direct my own care? Yes, where allowed, through participant direction.

What is the MED? Maine’s Medical Eligibility Determination, used for nursing facility and Section 19 eligibility.

What about Section 12? Section 12 Consumer Directed Attendant Services is a separate MaineCare program for self-directed attendants.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.